Nuclear medicine is a medical specialty that uses tiny quantities of radioactivity to produce diagnostic images. It also has a role in therapy for some thyroid diseases and certain tumours. Surveys have shown that nuclear medicine procedures are used significantly less in the United Kingdom than in many other countries ...
This is the second edition of this publication which was published for the first time in 1994. This edition is structured in four parts. The first is a calendar of events in London's health care during 1994, followed by a commentary by the editor. The third section presents the relevant ...
This is a report on a competition held in 1993 by the King's Fund to find excellent examples of large hospital developments which were opened in Britain between 1980 and 1990. The aims for both National Health Service and independent sector hospitals were: to offer a high quality of life ...
The author describes his visit to Zambia to advise on the development of a policy for hospitals at all levels and an approach to implementation. He visited the country from 27 February to 13 March 1994 to see the major types of hospitals. His recommendations for reforms are presented along ...
The author looks at the NHS in London two years after the report of the King's Fund Commission on London and the Tomlinson report and three years before the next general election. Policies shaping the NHS in London have become increasingly controversial. He argues that despite the growing resistance to ...
Reorientating the NHS to be both needs led and responsive to users has to be a joint endeavour for both commissioners and providers. A new synthesis is required to combine the best of personal patient care with a focus on population health. The King's Fund has recognised community oriented primary ...
The Innovation in Medical Education project, based in the Department of General Practice and Primary Care, King's College School of Medicine and Dentistry aimed to explore the implications of a substantial move of medical education into the community. The main areas covered were: interviews with a wide range of interest ...
This is the first issue charting the progress of developments in London's health services. Included are: a calendar of events from October 1992 to December 1993; a commentary on the development of the planning process in London including the series of reports from the Government and other professional bodies. There ...
The author describes the health problems of homeless people, concentrating on London, and how services for homeless people could be improved. This could be delivered within the National Health Service in an integrated service. The author also looks at why so few homeless people are registered with a general practitioner; ...
This paper proposes an alliance of charitable foundations, together with Government, to make a distinctive contribution to the way in which health services for Londoners are being shaped. It explains how an investment fund could form the basis of a high profile three year development programme; how it could be ...
This report makes proposals for the statutory registration and regulation of chiropractic to tackle the anomaly that anyone can claim to be a chiropractor in the United Kingdom, whether or not they have undergone professional training. The terms of reference for the report were: `Having regard to the growing public ...
This is a collection of short papers based on a seminar to mark the eighty fifth birthday of Sir George Godber. They examine issues of substantial relevance to the present and future of the National Health Service.
The aim of this unpublished paper is to provide all Londoners with primary and community health services which both meet their needs for high quality health care and which - over time - can appropriately substitute for certain services currently provided in acute hospitals. If Sir Bernard Tomlinson's recommendations are ...
This unpublished paper outlines a process for specialty reviews, following on from the recommendations of the `Report of the inquiry into London's health service, medical education and research' (London : Department of Health, 1992) in which it was recommended that working parties be formed under the direction of the London ...
These guidelines suggest how to produce literature for patients in hospitals which is clear, attractive and readable. The guidelines show what information might be included and how some of it might be written and laid out, but scope is left for managers to design and develop literature according to their ...
The first part of this briefing looks at the implications of the NHS reforms in theory and in practice and presents the six lines of enquiry which might be pursued. The second section discusses the particular impact of the NHS reforms on London which has maintained a very significant number ...
The second edition of 'The Nation's Health' is an extensively revised and updated assessment of trends in health status and public health policy and practice over the last decade. Its wide-ranging scientific analysis forms the basis for developing 17 health priorities and a clearly defined strategy for improving health over ...
The report attempts to review the main issues surrounding the funding and management of units providing dialysis services to people suffering from end-stage renal failure in the UK for the benefit of health service managers, renal physicians and other staff. The objective is to review the experience and information currently ...
This report is concerned with efforts to assure quality in medical care, focussing on quality assurance efforts affecting care provided by doctors and hospitals (and to a lesser extent nursing homes). The study examines quality assurance in Sweden, Federal Republic of Germany, Belgium and England as these represent a range ...
This paper takes a longer term look at the implications of measures to switch from institutional to community care, and the future role of carers. Tentative steps are being taken to forge a new relationship between formal and informal care systems; this report continues the debate into whether these are ...
This book describes in detail the routine administrative tasks that have to be done in hospital after a patient dies and suggests systems which will ensure that the tasks are carried out efficiently. It lays down clear standards for bereavement officers and hospital staff to enable them to provide the ...
The 'keepers' mentioned in the title of this book are workers in prisons, long-stay hospitals, homes for mentally retarded people and other total institutions. Their feelings about their work and about the institutions are presented here in twelve monologues selected from more than 60 interviews with workers in 27 different ...
The care given to a random sample of adults who died in 1987 is described retrospectively by relatives and others who had known them. Most praised, or were satisfied with, the care given by general practitioners but both the statistics and the quotations reveal some disconcerting inadequacies in this care, ...
On 22 June 1988 the DHSS hosted a conference on women's health. This volume contains the papers given by the speakers. The purpose of the day was to provide a forum for dispelling the myths and correcting some of the misunderstandings surrounding women's health. Papers presented included breast cancer, cervical ...
In this book, top clinicians and senior managers in health services from the UK, the US, Canada, Australia and New Zealand write about their experiences in solving difficult problems in a way that ensures that their organisations continue to strive towards quality services. They describe how they try to resolve ...
This paper is not intended as a critique of government policy, but rather as an exploration of the opportunities and constraints inherent in that policy and some of the processes which may be required to put the policy into effect. A fundamental tenet of this paper is that the needs ...
This project paper outlines some of the initiatives undertaken in the field of education and prevention of HIV infection in an area of low prevalence (Northern Ireland) and attempts to adduce some of the factors critical to achieving implementation of the programme, planning for which started at the end of ...
In May 1985, five young men aged between 18 and 21 moved out of Brockhall Hospital (a long stay hospital for people with learning difficulties) to take up the tenancy of their own home in Blackburn. They moved with 9.5 whole-time equivalent health service staff to help them to learn ...
Managers may not be covered by the codes of practice of doctors and nurses but they are having to consider the ethical framework within which they work. This book examines ethical issues in a practical manner. It covers a wide field of concern to managers with responsibilities they have to ...
This report summarises the literature on geographical variations in hospital admission rates in the UK and internationally. It is restricted to studies of inpatient admissions. It concludes that the examination of the variations provides invaluable insights into the nature and extent of medical uncertainty, and that this information is essential ...
This paper looks at the attitudes and behaviour in seeking health care of all the general medical practitioners in one family practitioner area - Avon. The results show that this group of doctors find difficulty in receiving help from other doctors, particularly for conditions to which doctors are most susceptible. ...
This booklet arose out of the work of Brunel ARMS Research Unit at Brunel University. The booklet has been written after talking to many carers, showing the variety in people's experience. The aim of the booklet is to show that a lot of people share the same experiences and difficulties ...
The sixth King's Fund Forum was held in London from 26 to 28 June. Five questions were addressed; what is the relationship between dietary fats, blood cholesterol and the levels of coronary heart disease; what individual or community-wide dietary or other interventions can reduce blood cholesterol levels and the risk ...
These guidelines have been compiled in response to an assessed need from hospitals for help with commissioning arts and artists. It is divided into seven chapters and includes guidance on the need for a committee; choosing a site; the commissioning process; fundraising. Its recommendations are based on 10 years of ...
This report is an evaluation of a ten week scheme by two artists in residency at St John's Hospice, Lancaster. It assesses the effect, beneficial or otherwise, the scheme had on the patients, staff and visitors at the hospice. The report explains the background to the project, then describes the ...
In 1988 the King's Fund covered a multi-disciplinary panel to consider the following questions and to prepare a statement for discussion at a consensus conference: is there scientific evidence that ICUs cause a decrease in morbidity and mortality; what criteria should be set for admission and discharge to intensive care ...
This is a fully revised and updated version of the 1987 edition. It describes applications of DRGs at hospital level and examines their use in policy matters at all levels of health services. It is for everyone interested in and responsible for the way resources are used.
The aim of this project was to discover whether the needs of people whose relatives die in hospital are being met within that setting. Surveys were undertaken to gain the views of both sides, by seeking both the experiences of bereaved relatives, and by ascertaining the procedures and practices of ...
The NHS is a vast and complex organisation, never out of the public eye and now the focus of major political argument. The author examines the way the NHS works and the incentives that motivate everyone concerned - the general public, the health professionals and managers, and the government. There ...
In 1977 an exploration into the use of counselling of visually impaired adult persons began in Richmond Adult College, Surrey, where it continued for 2 years. It moved to the ophthalmic department, King's College Hospital in 1980 and continued until 1987. The author formed a group in Richmond for people ...
This book is based on the first research study to look at the impact on women of a positive cervical smear and subsequent investigation and treatment. It follows their experiences from the initial discovery through to outpatient treatment or inpatient surgery. The authors describe the thoughts and feelings women have ...
This report draws on the work of two meetings. Firstly, a conference of the UK Conference of Postgraduate Deans and the National Association of Clinical Tutors on the present state of postgraduate medical education and training, at which they expressed the urgent need for a more critical examination of current ...
In June 1987 the King's Fund convened the first meeting of a working party on the future shape of paediatric surgery in the four Thames regions, with special reference to Greater London. The working party was composed primarily of paediatric surgeons. This document is their report. The emphasis is on ...
The fifth King's Fund Forum was held in London on 27-29 June 1988. Five questions were addressed: 1) What are the responsibilities of service providers for patients and their carers? ; 2) For presumed stroke sufferers what has been shown to be of diagnostic value? ; 3a) What treatments have ...
The philosophy of 'an ordinary life' has been the basis of a wide range of local initiatives, and increasingly influences large-scale changes in community care. This book includes contributions from seventeen people who as users, innovators and evaluators have been involved centrally in these developments. They review current practice in ...
This project paper has been written for staff concerned with resettling people who are being discharged from long-stay hospitals or who are developing housing schemes for people with serious psychiatric disabilities living in hostels or with their families. It attempts to distil the lessons from current examples of good practice ...
This publication reviews the progress in public health over the last decade. It seeks to interpret trends in health and to identify measures likely to be effective in promoting the public health. It outlines a national strategy for the next decade, identifying the public responsibilities of government and of the ...
This second edition reflects the significant growth in quality assurance activity, and an increased willingness to share experience and expertise amongst those involved in the field. The directory covers the 192 DHAs in England, and provides comprehensive data from Scotland, Northern Ireland and Wales. It includes a barchart comparing the ...
This is the third volume of King's College Studies in medical law and ethics. The following topics are covered: A.I.D.S.; contraception and family planning; human rights and the role of the judiciary in medical law; a national commission for medical ethics; defensive medicine and medical malpractice; the ethics of the ...
Rising health care costs now confront policy makers and planners with serious dilemmas of choice. This publication seeks to help formulate principles by which choices can be made. It begins with the premise that health demands will outstrip available resources, but argues that this should not mean that every allocation ...
The development of a network of services and support for people with A.I.D.S. is a challenge for voluntary agencies, for the NHS and for local authorities. There is a consensus that services should, as far as possible, be provided to enable people to be cared for in their own homes. ...
Case management means a number of different ways of managing care, ranging from client advocacy on one hand, to managing services and resources on the other. These, and other issues, are explored in the context of three experimental projects supported by KEHFL. The book reviews a number of dimensions of ...
The project was undertaken with the intention of clarifying and updating the original concept of the community hospital. In defining what community hospitals are, emphasis has been placed on their philosophy and on ensuring that their role is clearly understood.
Arthur Andersen and Co. Management Consultants has been involved with a number of research projects designed to measure value for money in health and local authority services. This booklet describes the components which they believe make up a successful joint planning exercise. Its purpose is to present some lessons and ...
This is the fourth paper published by the King's Fund and NAHA on the need to change the way in which pay is determined in the NHS. This paper outlines a proposed structure for determining pay, based on principles described in the earlier documents. The system has three elements: a ...
The author was asked to deliver the first of a series of annual lectures endowed by Gloucester Health Authority. She chose as the topic of her speech, critical choices, centring on economic and ethical problems in the provision of health care.
Although the development of community care has been national policy in Britain for at least thirty years, it means something quite different in England, Scotland and Wales. This book offers a comparative study both of the central government departments responsible for making and implementing policy for community care, and of ...
It is customary for the Fund's General Council to invite two speakers to talk about aspects of the Fund's work at its general meeting. On 6 June 1986, the first meeting to be held under the Presidency of HRH The Prince of Wales, the subject was the Fund itself. This ...
The introduction of general management into the NHS has transformed the service. The author asks if the NHS can continue to evolve into a more dynamic, responsive and actively managed service, representing even better value for money or will the transition to general management be arrested?
This volume describes in detail the organisation of resources and the distribution of doctors, nurses, physiotherapists, occupational therapists and others working in geriatric units. It also examines and compares different styles of geriatric practice. The authors argue that planning should be done on a national basis. They include suggestions for ...
This volume is the programme and abstracts of the consensus conference on screening for foetal and genetic abnormality and is for use by the panel and the audience as a reference guide to the deliberations of the conference. With the decline of infectious diseases as the major cause of perinatal ...
This book describes the first appointment of the Medical Officer of Health, and sets out the development of the office and its increasing responsibilities and achievements. An epilogue outlines the influences which led to the abolition of the post in 1974. This collection provides a timely opportunity to reconsider the ...
This report was commissioned from the King's Fund by the chairman of the twelve District Health Authorities. It was felt that there was a lack of a factual basis against which to assess the London-wide implications of the plans of the four Thames Regional Health Authorities. This report, which is ...
This is the first in the annual series of volumes on medical law and ethics based on lectures given at King's College London. The contributors, who came from a wide a range of disciplines and represent diverse interests, review important issues in the forefront of recent controversy, relating particularly to ...
The NIMROD service is recognised as being to the forefront of the move towards community care. This book uses a case-study approach to illustrate the experiences of seven people with learning difficulties who use this service. The case studies are analysed in terms of a number of interwoven concepts: presence ...
Tom Evans was Director of the King's Fund College from 1981 until his death in 1985. This book is a tribute to him. The papers cover a variety of management issues: an exploration of what strategic management and strategic planning mean; management in the NHS; accountability in the public sector; ...
The tour of North America on which this report is based gave health professionals from the UK an opportunity to study the ideas and practices of countries with different health care systems and an extensive experience of health promotion initiatives. The implications for this country contained in this book are ...
This is a fully revised and updated version of the 1987 edition. It describes applications of DRGs at hospital level and examines their use in policy matters at all levels of health services. It is for everyone interested in and responsible for the way resources are used.
This publication is addressed to members of health authorities, who have a key role to play in ensuring that their authority embarks speedily on the formulation of a policy for the care of the dying. It aims to assist health authorities in making informed decision about the pattern of services ...
At whatever age general practitioners retire, whether early, late, or at what is regarded as the conventional time (65), this is likely to have substantial implications for manpower planning - in the UK for example in connection with the demand for and establishment of vocational training schemes. A study of ...
Building community describes 30 different services, which between them, are offering family support, alternative homes for children and a variety of housing. They are working towards integration in ordinary local patterns of education, employment and leisure. They believe that everyone with a mental handicap has a right to a valued ...
This history begins with the foundation of the Lancet in 1823, and ends in 1982 with the restructuring of the National Health Service, when the management of hospitals in isolation from other health services had ceased. The opening chapters consider the endowed and voluntary hospitals, the poor law infirmaries and ...
This paper is addressed to a wide range of people concerned with the provision of care for people with learning difficulties their families. It is the result of research among parents whose adult sons and daughters with learning difficulties live at home, and explores their perspectives on the eventual move ...
In January 1980 the Conservative Government appointed a study group under Sir Donald Acheson to produce ambitious proposals for rapid and effective action on primary care in London. This report examines how and why the study group was established, the issues it confronted, the route by which it reached its ...
This is the report of an independent committee, chaired by Lady Margaret McCarthy, which undertook the review at the invitation of the Hospital Caterers' Association and with the support of a grant from the King's Fund. The committee was asked to investigate and report on the perceived needs of patients ...
This paper seeks to analyse how the role of district health authority members developed in the period around and after the 1982 reorganisation of the NHS, and it seeks to identify how the role of members can be strengthened within the existing framework of the NHS. Some ideas and principles ...
The discussion in this paper is based on the findings of a study supported by the King's Fund and conducted under the auspices of the Royal College of Radiologists Working Party on the Effective Use of Diagnostic Radiology in which four strategies were evaluated for implementing guidelines on the use ...
This research project is the result of collaboration by the following organisations:- The King's Fund; London Boroughs Training Committee; London Voluntary Services Council; National Institute of Social Work; Age Concern Greater London. It was financed by the King's Fund. The limits of altruism explores the social and psychological processes which ...
The causes of diarrhoea and the way it is brought about are presented as a consecutive narrative in readable form. Readers without medical knowledge will understand how the condition comes about, recognise the circumstances which give rise to the danger and have some inkling as to the precautions needed to ...
The ways in which hospitals administer patients' money and provide residents with access to their income play a large part in controlling the amount of money a resident can use. Because so little attention has been paid to the financial position of residents in long-stay hospitals it is not know ...
This book aims to provide an account of the range of work carried out by the Family Practitioner Committees, the bodies responsible, in England and Wales, for administering the contracts of general practitioners, dentists, opticians and pharmacists. This is the first comprehensive study of FPCs. It analyses the political environment ...
This is the first in an annual series of volumes on medical law and ethics based on lectures given at the Centre of Medical Law and Ethics, King's College London. The contributors, who came from a wide range of disciplines and represent diverse interests, review important issues in the forefront ...
This book is a contribution to managers' helping each other to learn. Most of the papers in the book are written by health service managers; they are not someone else's account of what those managers do or say they do, but the thoughts of the managers themselves on their own ...
This conference, held on 13 and 14 February 1986 was organised by the GLC with assistance from the King's Fund. This volume is a collection of edited conference speeches, workshop summaries and an information section. Nine key areas are identified:- prevention; medical practice; non-medical NHS workers; complementary alternative medicines; self-help; ...
The papers that comprise this collection are the proceedings of a workshop organised by the Department of Mental Health, University of Bristol, in May 1986. The workshop aimed to explore issues and strategies for ensuring quality in community services for people with mental handicap. The papers are organised and presented ...
This report is the responsibility of a Steering Committee set up by the Royal College of Psychiatrists, the Association of University Teachers of Psychiatry and the Association of Psychiatrists in Training. The book explains how a future psychiatrist embarks on a professional education, and the pathway along which educational training ...
This report, by a Brunel team led by Professor Maurice Kogan, was commissioned by the King's Fund at the request of the Department of Health and financed by the Department. It describes the Management Advisory Service in the Oxford and South Western regions, and Performance Review in Wessex, in the ...
Since 1948, doctors have had a powerful influence on national and local health policies. They have not, however, always had a happy relationship with the administration that had to implement the policies. Recently the argument for cost effective management, rather than just efficient administrators, in the NHS has been greatly ...
The aim of this study is to explore the effect of alternative methods of financing health services on health service performance - particularly performance with respect to efficiency and equity - in the United States, Canada and the United Kingdom. All countries face certain dilemmas in financing health services: health ...
This conference took place within the context of three related developments. Firstly, there was the wide-ranging debate about standard setting and the measurement of quality in public services. Secondly, there were the more specific concerns about standards of care in residential accommodation for the elderly, and thirdly, there was the ...
St Mark's colo-rectal hospital celebrated its 150th anniversary in 1985. It is the only colo-rectal hospital to survive in Britain and thus is unique. It is also a particularly distinguished example from a class of hospitals that developed in the nineteenth century in London and elsewhere to combat specific diseases, ...
The role of library services in the NHS is highlighted in this paper, which offers proposals for developing these services in response to the needs of all users. The proposals arise from a series of workshops held between May and December 1983, which were organised by a joint working party ...